Monday, September 14, 2009

Health care around the world

Excellent book review in today's Times about T.R. Reid's "The Healing of America".

Here's the best section:

When Mr. Reid presents his shoulder to his own orthopedist in Colorado, the doctor is quick to recommend a shoulder replacement. It will cost his insurer tens of thousands of dollars (assuming it agrees to pay), with unknown co-payments for him. Risks include all those of major surgery; benefits include a restored golf swing.

The same shoulder gets substantially different reactions elsewhere in the world.

In France, a general practitioner sends him to an orthopedist (out-of-pocket consultation fee: $10) who recommends physical therapy, suggests an easily available second opinion if Mr. Reid really wants that surgery, and notes that the cost of the operation will be entirely covered by insurance (waiting time about a month).

In Germany, the operation is his for the asking the following week, for an out-of-pocket cost of about $30.

In London, a cheerful general practitioner tells Mr. Reid to learn to live with his shoulder. No joint replacement is done in Britain without disability far more serious than his to justify the expense and the risks, and if his golf game is that important, he can go private and foot the bill himself.

In Japan, the foremost orthopedist in the country (waiting time for an appointment, less than a day) offers a range of possible treatments, from steroid injections to surgery, all covered by insurance. (“Think about it, and call me.”)

In an Ayurvedic hospital in India, a regimen of meditation, rice, lentils and massage paid for entirely out of pocket, $42.85 per night, led to “obvious improvement in my frozen joint,” Mr. Reid writes, adding, “To this day, I don’t know why it happened.”